沙美特罗氟替卡松对慢性阻塞性肺疾病患者骨代谢与骨密度影响的回顾性研究  

A retrospective study of the influence of inhaled Salmeterol fluticason in both bone metabolism and bone mineral density in patients with chronic obstructive pulmonary disease

作　　者：李学军[1] 司良毅[1] 王璋[1] 袁侨英[1] 

机构地区：[1]第三军医大学西南医院老年科,重庆400038

出　　处：《重庆医学》2010年第11期1375-1376,1379,共3页Chongqing medicine

基　　金：第三军医大学临床创新基金

摘　　要：目的了解沙美特罗氟替卡松对慢性阻塞性肺疾病（COPD）患者骨密度（BMD）和骨代谢的影响。方法收集2006年10月至2009年4月收治的中重度COPD住院患者132例及同期健康查体同龄对照组45例。COPD患者中曾经或正在规律进行吸入沙美特罗氟替卡松（50/500μg）治疗累积大于6个月者70例,未行沙美特罗氟替卡松治疗或使用时间小于6个月者62例。应用双能量X吸光测定法测定其腰椎（L2~4）和左侧髋骨（股骨颈、股骨Wards三角、大转子）的BMD和骨代谢相关的生化指标的变化。结果接受沙美特罗氟替卡松治疗的COPD患者BMD和骨代谢指标较未吸入者组差异无统计学意义（P〉0.05）,而COPD患者BMD显著低于健康体检的同龄对照组。结论长期吸入沙美特罗氟替卡松对COPD患者BMD无显著影响,COPD稳定期吸入沙美特罗氟替卡松维持治疗不增加骨质疏松发生的风险。COPD患者BMD显著低于同龄健康者。Objective To explore the influence of inhaled Salmeterol fluticason in both bone metabolism and bone mineral density（BMD） in patients with chronic obstructive pulmonary disease（COPD）.Methods 132 moderate to severe COPD patients were hospitalized in Department of senile disease,Southwest Hospital,the Third Military Medical University from October 2006 to April 2009 and 45 health volunteers were considered as control group.Of the 132 COPD patients,70 were inhaled Salmeterol fluticason（50/500 μg,twice per day）longer than 6 months,the others were not inhaled Salmeterol fluticason or inhaled it less than 6 months.The alteration of bone metabolism,BMD of and biochemical indicators correlated to bone metabolism were measured.Results There was no significant difference between the Salmeterol fluticason inhalation group and the control group in the measurement of bone metabolism,BMD and biochemical indicators correlated to bone metabolism（P〉0.05）,but BMD at L2~4 and left hip in patients with COPD were significantly lower than those in the control（P〈0.05）.Conclusion There is little influence of long-term inhaled Salmeterol fluticason on BMD,and the inhalation treatment with Salmeterol fluticason of stable COPD will not increase the risk of osteoporosis.

关 键 词：慢性阻塞性肺病 沙美特罗氟替卡松 骨代谢 骨密度 

分 类 号：R563.9[医药卫生—呼吸系统]